To amend title XXI of the Social Security Act to allow qualifying States to use allotments under the State children's health insurance program for expenditures under the medicaid program.

March 13, 2003

Mr. BINGAMAN (for himself, Mr. JEFFORDS, Mrs. MURRAY, Mr. LEAHY, and Ms. CANTWELL) introduced the following bill; which was read twice and referred to the Committee on Finance

To amend title XXI of the Social Security Act to allow qualifying States to use allotments under the State children's health insurance program for expenditures under the medicaid program.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. SHORT TITLE.

This Act may be cited as the `Children's Health Equity Act of 2003'.

SEC. 2. AUTHORITY FOR QUALIFYING STATES TO USE SCHIP FUNDS FOR MEDICAID EXPENDITURES.

Section 2105 of the Social Security Act (42 U.S.C. 1397ee) is amended by adding at the end the following:

`(g) AUTHORITY FOR QUALIFYING STATES TO USE CERTAIN FUNDS FOR MEDICAID EXPENDITURES-

`(1) STATE OPTION-

`(A) IN GENERAL- Notwithstanding any other provision of law, with respect to fiscal years in which allotments for a fiscal year under section 2104 (beginning with fiscal year 1998) are available under subsections (e) and (g) of that section, a qualifying State (as defined in paragraph (2)) may elect to use such allotments (instead of for expenditures under this title) for payments for such fiscal year under title XIX in accordance with subparagraph (B).

`(B) PAYMENTS TO STATES-

`(i) IN GENERAL- In the case of a qualifying State that has elected the option described in subparagraph (A), subject to the total amount of funds described with respect to the State in subparagraph (A), the Secretary shall pay the State an amount each quarter equal to the additional amount that would have been paid to the State under title XIX for expenditures of the State for the fiscal year described in clause (ii) if the enhanced FMAP (as determined under subsection (b)) had been substituted for the Federal medical assistance percentage (as defined in section 1905(b)) of such expenditures.

`(ii) EXPENDITURES DESCRIBED- For purposes of clause (i), the expenditures described in this clause are expenditures for such fiscal years for providing medical assistance under title XIX to individuals who have not attained age 19 and whose family income exceeds 133 percent of the poverty line.

`(iii) NO IMPACT ON DETERMINATION OF BUDGET NEUTRALITY FOR WAIVERS- In the case of a qualifying State that uses amounts paid under this subsection for expenditures described in clause (ii) that are incurred under a waiver approved for the State, any budget neutrality determinations with respect to such waiver shall be determined without regard to such amounts paid.

`(2) QUALIFYING STATE- In this subsection, the term `qualifying State' means a State that--

`(A) as of April 15, 1997, has an income eligibility standard with respect to any 1 or more categories of children (other than infants) who are eligible for medical assistance under section 1902(a)(10)(A) or under a waiver under section 1115 implemented on January 1, 1994, that is up to 185 percent of the poverty line or above; and

`(B) satisfies the requirements described in paragraph (3).

`(3) REQUIREMENTS- The requirements described in this paragraph are the following:

`(A) SCHIP INCOME ELIGIBILITY- The State has a State child health plan that (whether implemented under title XIX or this title)--

`(i) as of January 1, 2001, has an income eligibility standard that is at least 200 percent of the poverty line or has an income eligibility standard that exceeds 200 percent of the poverty line under a waiver under section 1115 that is based on a child's lack of health insurance;

`(ii) subject to subparagraph (B), does not limit the acceptance of applications for children; and

`(iii) provides benefits to all children in the State who apply for and meet eligibility standards on a statewide basis.

`(B) NO WAITING LIST IMPOSED- With respect to children whose family income is at or below 200 percent of the poverty line, the State does not impose any numerical limitation, waiting list, or similar limitation on the eligibility of such children for child health assistance under such State plan.

`(C) ADDITIONAL REQUIREMENTS- The State has implemented at least 3 of the following policies and procedures (relating to coverage of children under title XIX and this title):

`(i) UNIFORM, SIMPLIFIED APPLICATION FORM- With respect to children who are eligible for medical assistance under section 1902(a)(10)(A), the State uses the same uniform, simplified application form (including, if applicable, permitting application other than in person) for purposes of establishing eligibility for benefits under title XIX and this title.

`(ii) ELIMINATION OF ASSET TEST- The State does not apply any asset test for eligibility under section 1902(l) or this title with respect to children.

`(iii) ADOPTION OF 12-MONTH CONTINUOUS ENROLLMENT- The State provides that eligibility shall not be regularly redetermined more often than once every year under this title or for children described in section 1902(a)(10)(A).

`(iv) SAME VERIFICATION AND REDETERMINATION POLICIES; AUTOMATIC REASSESSMENT OF ELIGIBILITY- With respect to children who are eligible for medical assistance under section 1902(a)(10)(A), the State provides for initial eligibility determinations and redeterminations of eligibility using the same verification policies (including with respect to face-to-face interviews), forms, and frequency as the State uses for such purposes under this title, and, as part of such redeterminations, provides for the automatic reassessment of the eligibility of such children for assistance under title XIX and this title.

`(v) OUTSTATIONING ENROLLMENT STAFF- The State provides for the receipt and initial processing of applications for benefits under this title and for children under title XIX at facilities defined as disproportionate share hospitals under section 1923(a)(1)(A) and Federally-qualified health centers described in section 1905(l)(2)(B) consistent with section 1902(a)(55).'.

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